| NPI | 1649649203 |
|---|---|
| Former Name | STEPHANIE CARLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0000889) |
| 101YP2500X Counselor Professional (Licence: CO LPC.0015274) | |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2024-12-23 |